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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />-��3z �l�y <br />PROJECT ADDRESS <br />�� I �c,�.� <br />Owner <br />Tenanl <br />/a + � r l. <br />Eleclrical Conlractor <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�J- �32 iol <br />Mail Addross <br />Mail Addmss <br />� c iN�. ,� I°17 <br />Mail Address <br />_r �= Lr� r-_r_ �sj�� <br />Stale Lfcense Number <br />Proposed Use of Building <br />Doscriplion of Work lo Do Dono: <br />A��c F_ ve �e�T <br />City <br />Cily <br />�q�.ave �� <br />City <br />� <br />w� <br />State/Zip <br />Slale2lp <br />Phone <br />Pliono <br />� N�lac k w/� '7 �.0 7 Q <br />Slale2ip Phone <br />�3co� 73� � <br />/,� o 0 <br />Conlracl Price of Work <br />Contact Person (Plan Review) <br />NnTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />1 hereby cerfi(y thaf I havo rend and exarnined this applicotion and Miow the samo fo be lruo and <br />correct. All provfsions o//aws and ordinances govemmg this type o( work will 6e complefed <br />nhether specified herein or noL Tho gmnfing ol p pennrt does not prosumo to givo aufhonty fo <br />violafe or cancel tho provlsrons olany o0�er stafo or local la�v regulafing construcfion or fhe <br />pedomrance olconstruction. Thaf I arn aufhoNzed by the owner o(Ihis properfy fo pedom� the /\� <br />�vork lor which applicafion is made and l compty tvifh tho State Contractors Law 18.27 RCW and 1 <br />296.200 WAC. �O G1 � — <br />� /I— - ��.�/�-�l A..� � ����'I �b <br />� na re Dale <br />�� <br />